Moving Forward After COVID With a Hybrid Model of Care Due to the Benefits of Telerehab
June 2020
Over the last several months we have been doing TeleRehab or Virtual Visits due to the Covid 19 restrictions. It has been a very enjoyable and successful mode of communication and assessment for both the physiotherapist and the client! Traditionally, on initial assessment, I would spend an hour with clients. Usually, the first half hour was spent obtaining consent for physiotherapy assessment and treatment, review of the intake forms the client would have filled out previously online and addressing any questions and concerns. The second half hour would be a physical assessment and then we would discuss the findings, set goals and outline treatment(see my blog "What to Expect on your First Visit"). In the past, we have had long waitlists to get in for an assessment due to the difficulty in finding an hour time slot in our busy schedule. As we return to the clinic, both the client and I will be required to wear masks as a health precaution. As we all know by now, these masks are not so comfortable to wear and it is hard to communicate well through them. It is for this reason I would like to move forward with a Hybrid model of Care. This means I would like to continue to do the first half hour assessment Virtually and then do the physical assessment in the clinic. Most Insurance companies have recognized TeleRehab services and cover the costs.
So what is TeleRehab or Virtual Visits and how does it really work? Telerehabilitation refers to the delivery of rehabilitation services via information and communication technologies. It functions like FaceTime or Skype. We are using Zoom Healthcare provided through Embodia or the Jane platform provided through the Jane online booking system. Both are double encrypted and compliant with the Health Insurance Portability and Accountability Act(HIPAA).This means that there is privacy of health information, security of electronic records, administrative simplification, insurance portability and has detailed instructions for handling and protecting a patient's personal health information.
Clinically, TeleRehabilitation encompasses a range of rehabilitation services that include consultation, assessment, monitoring, intervention, supervision, and education. This means that we can cover exactly the same information we would if we see you in person for that first half hour of the assessment. However, the benefits include:
1. Doing the visit from the comfort and safety of your own home! Sometimes that might be challenging to find a quiet space but there is no travel involved! Most of the clients over the last several months have really enjoyed this convenience. It does work best if you are in a quiet room and have space to stand up or lie down(even on the floor with a yoga mat) with the ability of the camera to focus at the various levels.
2. Review and analysis of all the intake questionnaires(which can seem like a lot to go over since the questions are very detailed).
3. Doing evaluations of the posture, breathing pattern, rectus diastasis(abdominal separation), range of motion testing, strength testing and watching movement patterns.This contributes to an overall picture of what is going on in the body.
4. At the end, we summarize what the reported issues are, the treatment approaches to the issues and even start on some treatment modalities such as postural correction, breathing exercises, yoga, stretches or strengthening exercises. Education around the issue is also very important.
This is a lot to cover in a half hour but we get it done!
It is my suggestion moving forward that we do this first part of the initial assessments virtually. Then, we can do the rest of the physical assessment in the clinic for the second half hour. This is what it means to be a Hybrid Model of Care. It will provide a lot more flexibility for scheduling and hopefully less wait lists.
For those who may not have access to a cell phone or computer, we can do the first half hour assessment by phone.
I look forward to meeting you each first virtually and then in person!